加利福尼亚州洛杉矶市和科罗拉多州丹佛市社区招募的注射吸毒者中多发性皮肤脓肿的危险因素：一项横断面研究。
Risk factors for multiple skin abscesses among community-recruited people who inject drugs in Los Angeles, CA, and Denver, CO: a cross-sectional study.
作者信息
Ganesh Siddhi S, Portillo Gilbert A Orta, Trigo Daniel R, Ninh Katrina, Gonzalez Karina Dominguez, Wilkins Patricia, Kovalsky Eric, Corsi Karen F, Barocas Joshua, Bluthenthal Ricky N
机构信息
Keck School of Medicine, Department of Population and Public Health Sciences, University of Southern California, 1845 N Soto St Los Angeles, CA 90032, USA.
Keck School of Medicine, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.
出版信息
Ther Adv Infect Dis. 2025 Jun 25;12:20499361251344765. doi: 10.1177/20499361251344765. eCollection 2025 Jan-Dec.
INTRODUCTION
Skin abscesses are one of the most common infections among people who inject drugs (PWID).
OBJECTIVE
To examine factors associated with the frequency of abscesses in the previous 3 months among PWID.
DESIGN
We conducted a cross-sectional analysis of baseline data from a prospective longitudinal cohort of PWID.
METHODS
Between April 2021 and November 2022, PWID were recruited from community settings in Los Angeles, CA, and Denver, CO. Participants completed an interview covering sociodemographic, drug use, and related risk behaviors. Participants were asked if they had abscesses in the last 3 months. Those reporting "" quantified the number of abscesses. Responses were classified as , 1, or 2 or . We used bivariate analysis and multi-nominal regression to examine factors associated with the frequency of abscesses.
RESULTS
Among participants ( = 472), 62% reported no abscesses, 16% reported 1 abscess, and 22% reported 2+ abscesses in the last 3 months. Compared to participants with no abscess, 1 abscess was associated with receiving buprenorphine treatment (adjusted odds ratio (AOR) = 3.27; 95% CI = 1.58, 6.78), being injected by another person (AOR = 3.06; 95% CI = 1.72, 5.45), injecting 3+ times a day (as compared to less than daily, AOR = 2.92; 95% CI = 1.28, 6.65), licking syringe prior to injection (AOR = 1.96; 95% CI = 1.03, 3.74), and being Latino (AOR = 0.25; 95% CI = 0.12, 0.54). Having 2+ abscess was associated with daily heroin use (AOR = 2.35; 95% CI = 1.26, 4.39), being injected by another person (AOR = 1.92; 95% CI = 1.16, 3.18), daily methamphetamines use (0.50; 95% CI = 0.30, 0.83) and those reporting 10+ rushed injection (as compared to none, AOR = 1.85, 95% CI = 1.04, 3.29) in the last 3 months.
CONCLUSION
Our findings underscore a multi-level approach to reducing abscesses in this population. Increased education around safe injection practices, institutional interventions-that is, addressing healthcare stigmatization and expanding clinical harm reduction-as well as structural interventions (safe supply, overdose prevention programs, housing) should be considered.
引言
皮肤脓肿是注射吸毒者（PWID）中最常见的感染之一。
目的
研究与PWID过去3个月内脓肿发生频率相关的因素。
设计
我们对一个前瞻性纵向队列研究中PWID的基线数据进行了横断面分析。
方法
在2021年4月至2022年11月期间，从加利福尼亚州洛杉矶和科罗拉多州丹佛的社区环境中招募PWID。参与者完成了一项涵盖社会人口统计学、药物使用及相关风险行为的访谈。询问参与者在过去3个月内是否有脓肿。报告有脓肿的参与者需量化脓肿数量。回答分为无、1个、2个或更多。我们使用双变量分析和多项回归来研究与脓肿发生频率相关的因素。
结果
在472名参与者中，62%报告无脓肿，16%报告有1个脓肿，22%报告在过去3个月内有2个或更多脓肿。与无脓肿的参与者相比，有1个脓肿与接受丁丙诺啡治疗相关（调整后的优势比（AOR）=3.27；95%置信区间（CI）=1.58，6.78）、由他人注射（AOR=3.06；95%CI=1.72，5.45）、每天注射3次以上（与每天少于1次相比，AOR=2.92；95%CI=1.28，6.65）、注射前舔注射器（AOR=1.96；95%CI=1.03，3.74）以及为拉丁裔（AOR=0.25；95%CI=0.12，0.54）有关。有2个或更多脓肿与每日使用海洛因相关（AOR=2.35；95%CI=1.26，4.39）、由他人注射（AOR=1.92；95%CI=1.16，3.18）、每日使用甲基苯丙胺（AOR=0.50；95%CI=0.30，0.83）以及那些报告在过去3个月内有10次以上快速注射（与无快速注射相比，AOR=1.85，95%CI=1.04，3.29）有关。
结论
我们的研究结果强调了采用多层次方法来减少该人群中的脓肿。应考虑加强关于安全注射做法的教育、机构干预措施，即解决医疗污名化问题并扩大临床减少伤害措施，以及结构性干预措施（安全供应、过量预防项目、住房）。
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